NPIMap

Individual provider Active NPI

William David McClendon Jr., MD

  • General Practice Physician
  • Pascagoula, MS
National Provider Identifier
1790735652
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
18910 Issued in MS
Practice address
2809 Denny Ave
Pascagoula, MS 39581-5301
Phone
(228) 809-5510
Fax
(228) 809-5519
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 18910 MS Primary

Addresses

Primary practice location

2809 Denny Ave
Pascagoula, MS 39581-5301

Mailing address

1161 Robinson St
Ocean Springs, MS 39564-3841
Phone (228) 244-9910

Other identifiers 1

IdentifierTypeStateIssuer
08070043MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051011000678 MS Practitioner - Internal Medicine 5496770208 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Mississippi School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
McClendon Medical Clinic PLLCGroup PAC ID 6103129945, 5 clinicians

Practice addresses (Care Compare)

22 C Doctors Dr
Ocean Springs, MS 39564-5721
Phone (228) 244-9910

Hospital & facility affiliations

  • Vitalcaring Group Home health agency, Gulfport, MS, CCN 257090
  • Deaconess Homecare- Region I Home health agency, Laurel, MS, CCN 257085
  • Saads Home Nursing of Ms Home health agency, Diberville, MS, CCN 257128
  • Adoration Home Health Home health agency, Biloxi, MS, CCN 257100
  • Vitalcaring Group Hospice, Wiggins, MS, CCN 251684
  • Traditions Health Hospice, Ocean Springs, MS, CCN 251679
  • Singing River Gulfport Hospital, Gulfport, MS, CCN 250123
  • Singing River Health System Hospital, Pascagoula, MS, CCN 250040
  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18910MSMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Traditions Hospice of Biloxi, LLC CurrentSince Aug 1, 2022 Accepting new patients
Traditions Hospice of Biloxi, LLC CurrentSince Aug 1, 2022 Accepting new patients
McClendon Medical Clinic PLLC CurrentSince Dec 1, 2015 Accepting new patients
Newton Hospital, Inc. Past Accepting new patients
Newton Hospital, Inc Past Accepting new patients

Locations

3704 Bienville Blvd
#A3
Ocean Springs, MS 39564
Phone (228) 207-0390

1161 Robinson St
Ocean Springs, MS 39564
Phone (228) 244-9910

22C Doctors Dr
Ocean Springs, MS 39564
Phone (228) 244-9910

8150 N Central Expy
Ste 1800
Dallas, TX 75206
Phone (469) 501-1602

Interoperability endpoints

  • Direct secure messaging: jmcclendon4391@direct.mysrhs.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 69

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 69

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1790735652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 ROBINSON ST",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643841",
            "telephone_number": "228-244-9910",
            "fax_number": "228-244-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 DENNY AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395815301",
            "telephone_number": "228-809-5510",
            "fax_number": "228-809-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLENDON",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MS",
            "license": "18910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08070043",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

Verify at the official NPI Registry.